Agoraphobia - Shopping and Panic

The more crowded the shopping area is, the more panic will follow | Source

The translation of agoraphobia in its original form is "fear of the marketplace," but we commonly understand it as a fear of open spaces. Is this the real picture, though? Usually people will experience a panic attack in the early stages of their agoraphobia, and it is this panic attack that can be the trigger to keeping the phobia alive—even rendering those people prisoners in their own homes. Sufferers begin to fear having another panic attack whilst outdoors. They fear making a fool of themselves in public and not being able to escape the situation.

Many see their homes as their safe haven and the need to escape back to their abode becomes a priority. It’s easy to see how people begin to avoid activity outside of their safe haven and the problem intensifies. Panic attacks and avoidance become the issues to maintaining an agoraphobic problem. It becomes more of a fear of experiencing fear, in this case publicly. Some people may have convinced themselves they may pass out or have a heart attack but for most the ultimate fear is not being able to escape from what they perceive to be the public show of their terror.

Sudden feeling of impending doom whilst in a store | Source

An agoraphobic will fear any situation from which they feel they can’t escape so all social activities outside of the home become a trial. Eating out, socializing in general, travel, using public transport and shopping increasingly become avoided. In this article I want to look at what happens to these people when they attempt to go shopping and give some tips on how to address this particular issue.

Mrs Smith used to enjoy shopping until one day whilst in the middle of a large store she experienced a strong feeling of apprehension as if something terrible was about to happen. She didn’t know why and it frightened her. Suddenly she could feel her heart beating very fast, she became sweaty, shaky and her legs felt like jelly. These physical sensations convinced her something was terribly wrong with her and her fear spiralled. What if she were to suddenly pass out here in the middle of the store? She could imagine a crowd around her and the sound of ambulance sirens in the background. Maybe she was having a heart attack?

She looked around her and although people seemed to be shopping normally she felt she wouldn’t be able to disguise what was happening to her. She grabbed at a shelf to steady herself but she daren’t move. She now had vague pains in her chest and a feeling of not being able to breathe. She needed help and quick. As a store attendant walked close by she beckoned to her. She told the attendant she was going to pass out or she was having a heart attack. Concerned, the attendant called for another member of staff and Mrs Smith was gently guided to lie on the floor. She could hear the urgency in their voices as it was decided to call an ambulance.

By this time a crowd of shoppers had gathered to watch until Mrs Smith was attended to by paramedics. She was taken to hospital where the diagnosis was a panic attack. Her husband picked her up from the hospital and as soon as she got home she felt safe and much better.

An agoraphobic will always know where the exit is! | Source

This scenario may be all that is needed to kick start an agoraphobic problem. After this experience, Mrs Smith now associates shopping and that store in particular with a panic attack, something and somewhere to be feared. Because she has been told there is nothing physically wrong with her she assumes the store itself has caused her to become ill in this way and if it could happen once then surely it could happen again. She is now very apprehensive, as if it could happen whilst out shopping it could happen anywhere! She may or may not attempt shopping soon after this but if she does she certainly avoids that store.

Some weeks later she experiences the same scenario in a different store but this time she knows from experience that if she can just get home she will probably be ok. She rushes out of the store at the first signs of fear and jumps into a cab to take her home where indeed she feels much calmer. Now she knows what to do? The trouble is that her avoidance increases and only rarely will she venture out to do the shopping. She doesn’t want people seeing her having a panic attack or the huge fuss that might ensue. More importantly she just does not want to feel so terrorized any more.

It is the anticipation of the terrible outcome, the fear of feeling the fear in a shopping mall that causes the avoidance. It is not that store or that place that is to be feared but your reaction to the sensations produced by an initial adrenaline rush of pure fear; the urgent feeling of a need to escape to whatever you perceive to be your safe place and the fear of embarrassment in public.

It is unusual for another person to notice someone having a panic attack in a store. It is more likely that people will notice if the person having the panic attack draws attention to their plight. People are too busy shopping with other things on their minds to notice what’s going on around them. Panic attacks are more common than you think anyway and believe it or not there will be someone in that store who has had a panic attack themselves or knows someone who has.

So firstly, there is no shame in having a panic attack. It happens and to more people than you think. So, what can you do to address this particular problem of phobia and fear with regard to shopping?

Do not try to escape! Stay in that store. Remind yourself immediately you feel those first sensations that you will be fine. You know what this is. Yes it will still be scary the first few times but the more you stay without trying to escape the easier it will become. Don’t be tempted to rush out or rush through the checkout, take some deep breaths and carry on. No one can see what you are thinking or feeling. Although your legs may feel weak believe me they will get you through your shopping fine. There’s nothing wrong with your legs and you have a high chance of not passing out because your blood pressure rises from the effects of your fear.

Make eye contact with people if possible, it will remind you of the reality, that you are ok. Check out the goods on the shelf. Compare prices, look for a treat, anything other than rush about. Rushing will speed up your adrenaline even more. Perhaps have a quick mantra ready that you can use. Something like, I will be fine; I will not add more fear. This may sound rather impossible to some sufferers but staying with your fear and seeing it through is the only way to diminish that fear.

Don’t be deterred if it doesn’t work the first time. It takes practice but each time you stay with it all the shorter the suffering will be. You could even set a time on it all if you are finding it too difficult and gradually increase the amount of time you stay in the store.

I don’t want to give the impression I think this is easy. Practice and determination will rid you of your fear of shopping. The more you address the easier it all becomes. I know because I had this problem for years, and I conquered it.

NHS Information on Agoraphobia

Agoraphobia - NHS ChoicesFind everything you need to know about agoraphobia including causes, symptoms, diagnosis and treatment, with links to other useful resources.

What is the Best Therapy for Agoraphobia?

What therapy have you found to be the most helpful in dealing with your agoraphobia?

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

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